Better Health - April 2019

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Better Health D

GUT TROUBLES: a look at common digestive tract disorders, D2 SPRING ALLERGIES: woes and treatments, D3 WOMENS SHOES: a podiatrist weighs in on shoe concerns, D4

| SUNDAY, APRIL 14, 2019

|

Ever utter the phrase,

“Oh, my

poor feet ... they are

killing me.”

By Anne-Gerard Flynn

structure issue there is a lot I can do surgically.” If so, you are not alone. Surgery can help straighten Surveys have shown that 77 a hammer toe and there is percent of Americans have a small implant that can be experienced foot pain. thread into a joint just below Surveys have shown as well the ankle joint to help give that nearly one quarter of someone with a flat foot issue that is bothersome more of Americans spend six hours or an arch without extensive more standing on their feet surgery. daily. April serves as Foot Health Peteros said, “The No. 1 Awareness Month, and a condition people come to see good reminder to assess any me most often for is plantar ailments of these body parts fasciitis, which is kind of synon which we are estimated onymous with heel pain.” to walk 115,000 miles in our “It can be in the arch as lifetime, the equivalent of well but mostly in the heel,” about four times around the Peteros said. world. “People experience pain Many Americans do not first thing in the morning seek a diagnosis for their when they step out of bed or foot ailments, relying on later in the day when they have been on their feet all the self-treatments with varying time and there is a strain on a degrees of satisfaction, but structure called the fascia on there are doctors – podiatrists the bottom of the foot.” – who specialize in treating a What kind of footwear is Peteros said, “There are a range of conditions affecting suitable? number of things for plantar the foot, ankle and structures “Stiffer is better, especially fasciitis.” of the leg with medical as well when it comes to sneakers. A “We will use anti-inflamas surgical therapies. lot of these new ones are what Foot issues are often assomatories when appropriate I call fashion footwear and ciated with aging and certain fashion sportswear. Flimsy, as certain people can’t take chronic diseases, but Dr. them. Cortisone injection flexible,” Peteros said. when appropriate. I don’t like Christopher Peteros’ patient “If you can bend them right to do this right away but it can population has ranged in age in half at the arch level, the be done,” Peteros said. from children to adults into shoe is not good support. “We can custom-make their 90s during his more Stiffer shoes throughout the orthotics from a digital image than 25 years in practice. arch support are a better bet.” Asked about common of the foot, much like a denHe added, “Flip-flops are complaints such as bunions, tist does from the crown of a fine for the purpose they were - Dr. Christopher Peteros calluses, ingrown toenails tooth, if the over-the-counter intended - sitting around the and warts he quickly says he supports aren’t working, and pool, at the beach, on the back sees “all of them every day.” “Going to the grocery store bent toe, makes it rub into the and by the time you have got- we can do shock wave therapy deck having a drink.” Asked what is the most shoe and you get the corn,” ten it down to where you want which is really sound waves “There are sandals that are for an hour or two is not a common way Americans and done with the same type good idea.” Peteros said. it to be you have irritated the fine. Birkenstocks, some of abuse their feet, the Longof machine that breaks up Peteros listed corns and “On the bottom of the foot skin enough that it will build the European-, German-type meadow-based podiatrist’s calluses, considered signs it is usually from a prominent the skin back up faster so you kidney stones with sound sandals have good arches few-word answer is “with waves. We put the machine bone called the metatarsal are chasing your tail.” built into them. You can wear of the body trying to protect up against the heel and that is improper footwear.” sensitive skin areas, as among head or from lack of a fat pad. “If I shave it with a sterile sandals, they just have to be “This is the probable No. 1 very successful in people who the most frequent conditions A lot of the elderly lose that surgical blade,” Peteros said, more supportive,” Peteros way or no shoe-wear, walking said. have had very difficult cases. he sees daily. fat pad on the bottom of the “the skin does not know I It is a great option to surgery barefoot constantly. The foot He termed them a “result of foot and the bones become did anything to it and it stays “I tell my patients that they and, finally, we can operate if is just not made for it,” said direct pressure or excessive more prominent and there is gone awhile, but it comes think they are comfortable we have to.” Peteros whose practice, New pressure on the skin.” not a natural cushion between back unless the pressure is wearing a flip-flop, but your England Foot Specialists, in“So, wherever there is the skin and the bone and relieved.” foot is really working hard to keep it on. Toes are grabbing a pressure point, you can the skin senses it and builds He adds, “If you have a foot SEE FEET, PAGE D3 cludes associate Dr. Cynthia Special to The Republican

Galavotti. “The foot,” he adds, “needs support.” “We don’t have hoofs, and we all have different foot structures. We see people with high arches, people with low arches,” said Peteros, a graduate of Dr. William M. Scholl College of Podiatric Medicine at Chicago’s Rosalind Franklin University of Medicine & Science who did his residency at Cambridge Hospital, part of a Harvard Medical School teaching affiliate. “So, if you have an arch that is not particularly strong, walking around barefoot constantly or in flip-flops puts a lot of stress on the foot. One of the most common afflictions people get is plantar fasciitis, heel pain, arch pain.”

and scrunching, your heel is sliding back- and-forth so you are actually doing work.” Peteros said “very high heels push the foot forward, jam the toes and really the foot does not operate normally.” “Normally, when the foot hits the ground to walk it goes heel to toe,” Peteros said. “It goes from a motion we call pronation, which is a normal motion, and high heels take that away. You are kind of marching in a high heel.” He said a heel “an inch- to an inch-and-a-half “is “probably not a big deal if it is not a chronic thing.” “You are wearing them to go out to dinner. Perfectly fine for what it is built,” Peteros said.

build up a callus and more accurately wherever there is a callus there is a pressure point. It has to be. It would not exist if there was no pressure,” said Peteros of calluses often found on the bottom of the foot and corns “like a little rock” on the side or top of a toe. “What happens either in a shoe on the side or top of the toe, or on the bottom of the foot, excessive pressure builds up, the skin senses it, builds up extra skin to protect itself and does not know when to stop so it keeps going,” Peteros said. Pressure points, Peteros added, are often caused by a foot’s structure and not that of the shoe. “A hammer toe, which is a

something thicker.” Pressure points can be addressed with surgery as well as with other options as a short-term fix. “A shoe with a little bit of cushioning helps, and certainly orthotic supports can be made specifically to fit the shoe,” Peteros said. Podiatrists can also shave calluses to help reduce the time it takes them to return. “Find a podiatrist who will shave it down with a sterile blade,” said Peteros when asked about home remedies for a callus. “People cut themselves doing this, they get infected, and there are not a lot of products out there. You are going to rub a callus a long time to get it down with a pumice stone

“So, if you have an arch that is not particularly strong, walking around barefoot constantly or in flip-flops puts a lot of stress on the foot. One of the most common afflictions people get is plantar fasciitis, heel pain, arch pain.”


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D2 | SUNDAY, APRIL 14, 2019

THE REPUBLICAN | MASSLIVE.COM

Understanding

Dental

gut troubles

technology

Navigating the common disorders of the lower digestive tract.

Helping ease patient anxiety

Here is Dr. Dores consulting with a patient (HOANG ‘LEON’ NGUYEN / THE REPUBLICAN)

By Keith J. O’Connor, Sr.

HMC GI Team Photo (left to right): Mary Norris, MD; Ruby Malik, MD; Dale Pappas, PA; April Bowers, NP; & Tuyyab Hassan, MD

THE SYMPTOMS aren’t fun to talk about, but persistent diarrhea, constipation, bloating or abdominal pain can indicate a disease of the lower digestive tract. Here’s a quick overview of the most common culprits: · Irritable bowel syndrome (IBS) affects 25 to 45 million Americans, more than two-thirds of them women. It causes abdominal cramps, gas, bloating, constipation and/or diarrhea. If you have IBS, you should identify the foods that seem to cause problems so you can avoid them—and find other sources for the nutrients they provide. Your doctor may recommend over-the-counter medications for diarrhea or constipation, whichever is your primary symptom. · Diverticulosis is a condition in which small pouches or bulges called diverticula form in the digestive tract. It affects about half of all Americans older than 60. Many people with diverticulosis feel no symptoms; others may have gas, abdominal cramps, bloating, diarrhea or constipation. If you have diverticulosis, diet and exercise can help. Cut down on high-fat foods, eat more

foods high in fiber and try to exercise for 30 minutes a day most days. · Diverticulitis, inflammation in the diverticula, affects about 10 to 25 percent of people who have diverticulosis. It causes fever, nausea and abrupt pain, usually in the lower left part of the abdomen. Treatments include dietary restrictions, antibiotic medications or—especially if it’s recurrent—surgery to remove the diseased portion of the colon. WHEN TO SEEK CARE Lifestyle changes and medications can ease symptoms for many patients with these digestive-tract conditions,

says Holyoke Medical Center gastroenterologist Rubeela Malik, MD. “For example,” she adds, “if you have constipation and it doesn’t improve after you increase your water intake and add more fiber to your diet. Also seek care immediately if your symptoms are associated with abdominal pain (especially if it wakes you up from sleep), fever, weight loss, blood in the stool or black and tarry stools.” If you experience persistent gastrointestinal symptoms and follow-up specialty care is needed, ask your primary care provider for a referral to HMC Gastroenterology, now with five providers and

Lifestyle changes and medications can ease symptoms for many patients with these digestive-tract conditions, though surgery may be required for some. If symptoms like diarrhea, bloating and constipation aren’t getting better with diet and exercise changes or over-the-counter medications, see your doctor. though surgery may be required for some. If symptoms like diarrhea, bloating and constipation aren’t getting better with diet and exercise changes or over-the-counter medications, see your doctor,

accepting new patients. The office is located at 11 Hospital Drive in Holyoke. For questions, please call 413.540.5048.

“I have been using the Solea laser for four years after learning about it from a trade magazine, and then taking a course to be certified for its use,” Dr. Dores said. “Some patients don’t like the sound of the drill, the vibrations made by the drill touching the tooth, even with local anesthetic, and the ac-

replaces using a numbing gel. “Unless patients request the How many times have you gel, I actually avoid using it heard someone say, “I dread because it can cause patients going to the dentist?” to feel as if their throat is Why? numb and some patients find “It’s usually because they that uncomfortable,” Dr. have had a traumatic exDores said. perience at the dentist that “DentalVibe is awesome. involves pain and not feeling Patients rave about it. It is in control of the situation. an instrument that makes a So, some people who gentle vibration and already have a toothache pulsations during local avoid coming to the anesthetic injection. It dentist because they are actually blocks nerve pathways, pathways that afraid of the additional could trigger pain sensapain,” said Dr. James tions during the shot. It Dores of Dores Dental in also helps distribute the East Longmeadow. anesthetic fluid more But that doesn’t have evenly to the tissues beto be the case, noted Dr. ing targeted for numbDores, who is doing all ing,” he added. that he can to promote While the Solea laser “pain free dentistry” for can be used for almost his patients. every patient, it is not “I don’t want to build recommended for somefalse expectations by one who is pregnant. saying there will be no “The DentalVibe, pain, because that is a however, can be used tall order to deliver. But, for everyone. But, I have if I’m honest and tell found a few patients that patients what they might do not like the sensafeel, it is usually a better tion it causes, and they experience for them. opt for anesthetic the Oftentimes patients say traditional way. Also, they don’t feel anything This is the Solea CO2 laser technology some patients request to and that is what the goal machine at Dores Dental. (HOANG ‘LEON’ be numbed while using is. I use technology and NGUYEN / THE REPUBLICAN) the Solea laser, because a gentle touch to make their teeth are still very treatment as comfortable as possible,” Dr. Dores said. companying smells. The laser sensitive even when the laser The technology that the East works differently by numbing is used,” Dr. Dores said. In addition to being used for Longmeadow dentist is refer- the tooth with laser light, and ring to is the Solea® CO2 laser, can cut without any vibrations filling teeth, the Solea laser which is used instead of a or anything touching the tooth can assist during crown procedures by removing excess drill for procedures like tooth or the need for Novocain. gum tissues and making the fillings. And most procedures Most patients say they don’t performed with the high-tech feel anything when the laser is crown more accurate and tighter. It can also remove device require no anesthesia. used, only slight cold sensasome sores in the mouth. tions,” he added. For more information on the For those who do need an Solea laser and DentalVibe, anesthetic, especially when call 413-567-3170 or visit extracting a tooth, Dr. Dores doresdental.com. noted he has a new technology called DentalVibe® that Special to The Republican

James Dores, DMD,

graduated from the University of Connecticut School of Dental Medicine and completed his residency at the UCONN Health Center. Dr. Dores has been practicing dentistry in western Massachusetts since 2006 and opened his own practice, Dores Dental, in 2010. Dr Dores and his team participate in the annual Dentistry From The Heart, providing local people with basic dental care who otherwise may not afford to receive.

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SUNDAY, APRIL 14, 2019 | D3

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THE REPUBLICAN | MASSLIVE.COM

Allergist addresses

spring

allergy woes, treatments

By Anne-Gerard Flynn

Dr. Christopher Peteros is a Longmeadow-based podiatrist whose treatments for a common painful condition like plantar fasciitis might include laser therapy to stimulate healing and reduce inflammation in fibrous tissue on the bottom of the foot. (PHOTO BY ANNE-GERARD FLYNN)

Feet CONTINUED FROM PAGE D1

Peteros said the sound waves help to stimulate the healing process by reducing the inflammatory process to one “the body can handle.” He said he has had a “90 percent success rate” in “keeping people out of surgery” with it and has been doing it since 2002. Peteros said he also uses, with difficult cases of plantar fasciitis, a type of laser light physical therapy to penetrate into a cell’s mitochondria and boost the cell’s energy output to stimulate healing and reduce pain, inflammation and swelling “pretty quickly in a lot of people.” Peteros called bunions “one of the most popular things I fix surgically” and “not a bump.” He said bunions are “ge-

side, make a cut into the bone and push it where is it supposed to be,” said Peteros of the outpatient surgery he recommends when “it starts to hurt you on a regular basis” and after which people where a protective boot. “It is a realignment and not a removal of something. Most people can step on it the next day gently with crutches. Larger bunions take a longer period before weight bearing which is another reason not to wait too long to do it.” Peteros called plantar warts “another big one” he sees in his practice and ingrown toenails “huge.” “You get plantar warts from stepping on a virus somewhere like in a locker or hotel room. Patients don’t know where they got the virus from as the incubation period can be very long - 18 months - before it shows up,” he said. “We have all kinds of treatment options. Salicylic acid, freezing, burning them out, removing them surgically. There are different ways depending on how many they have and what is working and what is not.” Peteros said people are often surprised that podiatrists treat ingrown toenails. “I can’t tell you how many people come to me finally and say, ‘I did not know you could do anything about it. I have been struggling with this for years,’” Peteros. “I have a little procedure I can do right here in the office - a five-minute procedure with a little Novocain - that

Springfield was recently ranked fifth by the Asthma and Allergy Foundation of America in a report on the worst metropolitan areas for spring allergy sufferers. Dr. Jackie Garrett sees such sufferers as a board-certified allergist and immunologist based in the Feeding Hills section of Agawam with Trinity Health Of New England Medical Group. She was asked to explain the seasonal miseries suffered by millions of Americans across the country and what treatments are available. What are the first signs of Spring allergies you see in your patients this time of year? During this time of year, signs of allergies vary. Some patients experience symptoms of nose allergies: sneezing, clear runny nose or stuffy nose that lasts longer than the typical week that is expected with viral illnesses. They complain of constant symptoms with no improvement. Some patients experience eye allergy symptoms: itchy, red eyes, watery eyes. Some have also eye swelling and crusting. Those who have allergic asthma may be reaching for their Albuterol rescue inhalers more often, coughing more. They may also find themselves not feeling comfortable with outdoor sports. Lastly, some experience eczema flares with increased rashes. Why do our immune systems get so defensive about Spring? In the case of allergies, our immune system is making a mistake. Things in our day-today environment that should be perceived as harmless are being seen instead as a threat to the body. Because of this, we are left with nose allergy, eye allergy and asthma symptoms. The Asthma and Allergy Foundation recently ranked the Springfield area as the fifth worst place for Spring allergies on a list of 100 metropolitan areas. What factors in the Pioneer Valley contribute to such a ranking from an allergist’s viewpoint? The recent ranking looked at three factors: Pollen and mold counts; Use of allergy medicine and availability of board-certified allergists. Our valley location makes for a higher concentration of pollen exposure. Last year for instance, pollens were released in bursts because of the late cold weather. If you have several things pollinating simultaneously - trees, grass and weeds, for example, - in a valley location,

you are exposed to a higher pollen count that can lead to amplification of your symptoms. What over-the-counter treatments would you recommend to help most people ease their symptoms and is easing symptoms a good idea as opposed to just living with them? The best medication plan

toms are impacting your quality of life. For example, if you cannot take part in normal outdoor activity because your symptoms are making you so miserable. If your allergy symptoms are being complicated by sinus infections or eye infections. If you are using over-thecounter medications and they are not working, or if the side

“Our valley location makes for a higher concentration of pollen exposure. Last year for instance, pollens were released in bursts because of the late cold weather.” - Dr. Jackie Garrett

Board certified in allergy and immunology, Dr. Jackie Garrett is based in the Feeding Hills section of Agawam with Trinity Health Of New England Medical Group. (PHOTO BY ANNE-GERARD FLYNN)

for asthma, nose allergies and eye allergies is approximately a 15- to 20-minute test that involves skin prick testing to a panel of common allergens. At a certain age, patients can also undergo intradermal testing which is commonly an additional 20-minute test. If the skin and intradermal tests are negative, specific IgE blood testing to common allergens in the area can also be performed. There is a Northeast panel currently marketed. If medications are not working, you do not like taking medications or are having side effects from the standard medications, allergen immunotherapy (allergy shots) can be considered. After an eight-month to oneyear build-up period, they are typically given monthly for a period of 36 to 60 months with the goal of curing your allergies. They can literally make your allergies go away. Recently available are the FDA-approved sublingual (under the tongue) dissolving tablets currently on the market. These are mostly used for patients who have no time to come in for shots or just want something to make their symptoms less during an allergen season. There is more promising efficacy data coming out on these.

is dependent on your overall effects keep you from being health status. able to use them. Several years ago, prescripIf asthma symptoms are tion strength allergy medica- getting worse in the Spring. tions went over the counter, Environment allergy testing despite concerns voiced by the allergy and immunology community. These medications can be effective if used early enough, as directed and consistently in the right age groups. It is important to check in with your primary care provider or board-certified allergist to make certain that • Cosmetic Services there is no reason you should • Dental Implants not be using a particular aller• Digital X-rays & Records gy medication. • Dentures & Bridges The gold standard for nasal symptoms such as stuffy, run- • Endodontics ny, itchy is the nasal steroid • Same Day Crowns such as Nasacort, Flonase, • Surgical Procedures Rhinocort. • Quality Dental Twenty-four-hour antihisMembership Plan tamines can be helpful mostly with nasal symptoms like itch • Young Explorer’s Club or sneeze. Examples include Emergency & Evening Appointments Zyrtec, Claritin, Allegra, Xyzal. These can cause dry eyes 123 Dwight Road, Longmeadow though in certain populations. Antihistamine eye drops 413-567-1221 • flagshipdental.com can be helpful for eye itching or tearing. Ketotifen is an example. Eye drops that report to get Mental Health and Addiction Recovery Services the red out should be checked Available to all in the Pioneer Valley with your eye provider or primary care provider because this can alter your eye pressure. At one point should someone see an allergist for their symptoms and what tests or • Treatment for depression, anxiety, traumatic stress, and treatments might you be able other mood problems to recommend? • Psychiatric evaluations and medication services, as needed If you or your child’s symp-

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permanently removes it.” Peteros said another common condition is a neuroma, sometimes Morton’s neuroma, “which is a sharp pain between the third and fourth toes most netic and sometimes you often” and caused by tissue will see the same bunion in a that becomes thick around a family on the same foot.” nerve leading to a toe. “A bunion, which is basi“Morton’s neuroma cally a curvature of the big treatment many include a toe, is an angular deformity cortisone shot to shrink the between the big toe and the nerve or alcohol injections metatarsal. It is not a bump,” to damage the nerve and Peteros said. make it stop feeling pain or “People think they grew a nerve decompression surbump. Visually it is a bump, gery where I make a small, but it is a bump like my elhalf-inch incision that can be bow because it is bent. Once done somewhat noninvasiveit is straightened out, there is ly,” Peteros said. no problem.” He added fungal toenail He added, “When I do bun- infections are “fairly comion surgery, I am not actually mon” as well, though he said removing anything.” he often has to tell people “I am correcting an angle that “not every odd-looking where the first metatarsal is toenail is a fungal toenail. at an angle to the first toe. We loosen the tight ligaments up, tighten down the loose

Special to The Republican


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D4 | SUNDAY, APRIL 14, 2019

oatmeal can benefit your body oatmeal are often loaded with sodium and sugar, which can compromise the nutritional benefits of the oats. In fact, WebMD says some instant oatmeal packets contain as much as eight teaspoons of sugar per serving. Storebought plain rolled oats, or steel-cut oats, are typically nutritious and low in both Though brand name cereals sugar and sodium. For exor staples like bacon and eggs ample, Bob’s Red Mill® Extra might be the most popular Thick Whole Grain Rolled choices at the breakfast table, Oats contain just one gram few foods pack as nutritious a of sugar per serving and no punch as oatmeal. sodium. Instant oatmeal might be Oatmeal can provide a great found in the pantries of many start to your day and pay other households. But it’s important dividends as well, though it’s to note that packets of instant important that consumers

Oatmeal is one of many options people have when sitting down to breakfast each morning.

read package labels so they are getting the nutritional benefits of whole grain oats without the added sugar and sodium. The following are three of the many ways a morning bowl of oatmeal can benefit your body. 1. Oatmeal can help lower “bad” cholesterol. According to the Mayo Clinic, oatmeal contains soluble fiber, which can reduce the absorption of cholesterol into the bloodstream. And it doesn’t even take much soluble fiber to reap such benefits. Five to 10 grams of soluble fiber per day has been shown to decrease low-density lipopro-

tein cholesterol, which is commonly referred to as “LDL” or “bad” cholesterol. A single serving of Bob’s Red Mill® Extra Thick Whole Grain Rolled Oats provides 1.6 grams of soluble fiber, helping people get a healthy head start on lowering their LDL throughout the day.

THE REPUBLICAN | MASSLIVE.COM

mins, minerals and antioxidants. For example, half a cup of oats contains 41 percent of the RDI of phosphorous and 20 percent of the RDI of iron. That same serving contains 51 grams of carbohydrates and 13 grams of protein.

2. Oatmeal is loaded with vitamins and minerals. The online medical resource Healthline® notes that oats contain a well-balanced nutrient composition that can help people get well on their way to consuming their recommended daily intake of various vita-

3. Oatmeal can help people maintain healthy weights. Oatmeal, so long as it isn’t instant oatmeal, is one of the rare foods that’s both filling and low in calories. That makes it an ideal choice for those who want a filling breakfast that won’t affect

and their complaint and adds sometimes supports can be inserted to help address an issue. “I do get a lot of questions from women on shoes,” Galavotti said. “What I recommend depends somewhat on what your foot type is, that is, basically whether you have a high-arched foot, a normal rectus (well-aligned) foot or a flat foot (low or no arch). If people are having pain, we can recommend a custom-made orthotic or an over-the counter orthotic.” She said sneakers, too, should “have an arch” and adds brands she shops include Asics, New Balance and Saucony. She said that some companies “make sneakers for different foot types” with styles made to help “if a person is

an over pronator (rolls foot inward too much) or over supinator (places too much weight on the outside of the foot).” What qualifies as a supportive shoe, Galavotti said is generally “any type of shoe that has a forefoot base, and an arch.” “Sometimes I will recommend a heel, not a stiletto heel, for people who are having Achilles tendinitis pain (tissue connecting calf muscle at the back of the lower leg to the heel bone),” Galavotti said. “I would like to see them in a pump that has a forefoot cushion on it. This is good because when your rear foot is up, and your fore foot is down, you are putting all the pressure on your metatarsals (mid-foot bones) which will cause pain in the ball of your foot. But if you have a little bit of cushion

their waistlines. Oatmeal is filling because of its fiber content. Unlike other carbohydrates, fiber does not break down into sugar once it’s consumed. When fiber is consumed, it absorbs water and takes up space in the stomach, leading to feelings of fullness that can prevent overeating. The nutritional benefits of oatmeal make it a must-have item for anyone who wants to start their day off in a healthy way.

Podiatrist gets ‘a lot of questions’ from

women

on shoes

By Anne-Gerard Flynn

Special to The Republican

Cinderella had her glass slipper. Dr. Cynthia M. Galavotti has her Soffts, Borns and Clarks, and frequently advises her patients as a physician who treats the foot, ankle, and related structures of the leg, “It’s best to avoid shoes that have no support at all.” This means slipping instead into properly fitting shoes with an arch and some cushion for the ball of the foot. “Women come in because they are on their feet all day and they are wearing the wrong type of shoe for them in my opinion,” said Galavotti, a podiatrist and an associate of Dr. Christopher H. Peteros at New England Foot Specialists in Longmeadow.

“They are wearing flats - ballet flats or just regular flats.” When you wear a shoe with no support, she adds, “You might as well be putting paper over your foot and be walking around barefoot. You are not providing any service to your feet.” She adds footwear becomes a particular concern with aging as most people become “heavier on your feet.” “You need more structural support and shock absorption for your feet and you also need arch support as well,” Galavotti said. “The biomechanics of walking are that your heel hits the ground, your arch provides shock absorption for ground reactive forces and then you propulse off your big first toe joint.”

Dr. Cynthia M. Galavotti is a podiatrist and an associate of Dr. Christopher H. Peteros at New England Foot Specialists in Longmeadow. (PHOTO BY ANNE-GERARD FLYNN)

She adds, “When you are wearing a flat, you are setting yourself up for trouble and also plantar fasciitis (inflammation of tissue that runs across the bottom of the foot), especially on tile and wood floors because there is no cushion.” “If you could live your life walking on a cloud or very thick plush carpet, everything would be wonderful,” Galavotti said. A registered nurse earlier in her career, Galavotti became interested in podiatry while working in orthopedics at Massachusetts General Hospital. She returned to school, graduating in 1993 from the California School of Podiatric Medicine at Samuel Merritt University. She said what footwear she recommends depends on an individual’s foot structure

there for shock absorption, you are not going to have any pain. “ She said some women who need support for a high arch are among those who like a brand called Vionic. Galavotti, who recommends patients wear a “good sandal” as opposed to slippers at home, likes to joke that she “always thought I would open a store and call it ‘Pain-less Shoes.’” “I feel like a lot of women don’t know what to get for their foot type and I do feel they do buy shoes because they are pretty and go with the outfit,” said Galavotti who suggests patients instead look at brands whose shoes have support and style and can be worn for different occasions. She said this can save money over time – and possibly trips to a podiatrist.


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